目的 体外受精-胚胎移植(IVF-ET)后宫内外同时妊娠(HP)的临床观察及护理.方法 选取我院接收的IVF-ET后发生HP的患者20例作为研究对象,将其随机分为A组与B组,各10例.A组实施常规护理,B组实施个性化的心灵护理,对比两组患者的妊娠结局及临床护理效果.结果 治疗及护理前两组SAS、SDS评分比较,差异无统计学意义(P>0.05),护理后B组SAS、SDS评分低于A组,且正常妊娠率高于A组,差异有统计学意义(P<0.05).结论 对IVF-ET后发生HP的患者积极采取手术治疗,并且配合个性化临床护理,有助于缓解患者不良情绪,提高妊娠率.

体外受精-胚胎移植(IVF-ET)过程中常规的取卵方法为阴道超声引导下穿刺取卵。经阴道超声监测取卵术操作简单、方便,获卵率高,患者痛苦较小,易为患者接受。但由于操作中带有一定的盲目性,操作不当或当盐腔内器官解剖位置有变异时,易伤及邻近的肠管、膀胱、子宫、输尿管及血管等,从而导致瘘管发生或者大出血,严重时危及生命 [1] 。取卵术中损伤膀胱,可引起膀胱出血,而一旦血块填塞就会导

It is believed that endometrial miRNAs contribute to the etiology of endometrial dysfunction, however, the mechanisms remain unclear. Here we collected endometrial tissues from infertility patients with different thickness and characterized the miRNA expression profiles of these three groups. MiR-329 was dramatically down-regulated in infertility patients with endometrial hyperplasia. In addition, we found that miR-329 overexpression could inhibit CD146 expression in ESCs, which is a marker and is mainly expressed in the cytoplasm of ESCs. Moreover, bioinformatics analysis suggested that miR-329 was a regulator of CD146. Importantly, up-regulation of miR-329 in ESCs decreased cell proliferation, migration and invasion, and the underlying mechanism was mediated, at least partially, through the suppression of CD146 expression. Furthermore, PDGF increased cell viability, migration and invasion in a dose-dependent manner, PDGF-Rb antagonist, imatinib, could reverse PDGF-induced ESCs dysfunction through the activation of PDGF/PDGF-Rb-dependent signaling pathways. In conclusion, PDGF-Rb could play an important role in endometrial hyperplasia, and miR-329 via targeting CD146 associated with endometrial dysfunction and might be a potential therapeutic target against endometrial hyperplasia.

Background: The aim of this study was to determine the correlation between glucocorticoids (GCs) and insulin resistance (IR) in healthy individuals by conducting a systematic meta-analysis.Material/Methods: A systematic literature review was conducted using 9 electronic databases. Only case-control studies investigating fasting plasma glucose (FPG) and IR were enrolled based on strictly established selection criteria. Statistical analyses were performed by Stata software, version 12.0 (Stata Corporation, College Station, Texas, USA).Results: Among 496 initially retrieved articles, only 6 papers published in English were eventually included in this meta-analysis. A total of 201 healthy individuals (105 in GC group and 96 in control group) were included in the 6 studies. In 4 of these 6 studies, dexamethasone was used, and in the other 2 studies prednisolone was given. This meta-analysis revealed that the FPG, fasting insulin (FINS), and homeostasis model assessment of insulin resistance (HOMA-IR) levels in the GC group were all significantly higher than that in the control group (FPG: SMD=2.65, 95%CI=1.42-3.88, P<0.001; FINS: SMD=2.48, 95%CI=1.01-3.95, P=0.001; HOMA-IR: SMD=38.30, 95%CI=24.38-52.22, P<0.001).Conclusions: In conclusion, our present study revealed that therapies using GCs might result in elevated FPG, FINS, and HOMA-IR, and thereby contribute to IR in healthy individuals.

Background The aim of this meta-analysis was to determine whether genetic polymorphisms in the osteoprotegerin (OPG) gene contribute to increased risk of cardiovascular disease (CVD). Material/Methods Electronic databases were searched carefully without any language restriction. Analyses of data were conducted using STATA software. Odds ratios (OR) and 95% confidence intervals (95%CI) were also calculated. Results Seven clinical case-control studies that enrolled 1170 CVD patients and 1194 healthy subjects were included. The results indicated that OPG gene polymorphism might be closely associated with susceptibility to CVD, especially for rs2073617 T>C and rs2073618 G>C polymorphisms. Ethnicity-stratified analysis indicated that genetic polymorphism in the OPG were closely related with the pathogenesis of CVD among Asians (all P<0.001), but no obvious relationship was found among Caucasians (all P>0.05). Conclusions Our meta-analysis provided quantitative evidence that OPG gene polymorphism may be closely related to an increased risk of CVD, especially for rs2073617 T>C and rs2073618 G>C polymorphisms.

To investigate the clinical characteristics of patients with ovarian torsion under COS and the corresponding nursing intervention.Method:The clinical data of 5 patients with ovarian torsion in our reproductive centre from January 2010 to September 2013 were retrospectively analyzed,the reasons of the ovarian torsion and the corresponding nursing intervention were analyzed.Result:Among the 5 patients with ovarian torsion,the ovarian of 3 patients reset normal with one deliver a boy,one was abortion when 7 weeks of pregnancy and one was not pregnancy. The other 2 patients had the laparoscopic operation to treat the ovarian torsion. Among them,one patient preserved the ovarian and delivered a boy after transferred the frozen embryo and the other patients spayed the ovarian and had no pregnancy. Conclusion:The implementation of health education for the patients under IVF could improve their self protection consciousness. It is important to taking proper nursing measures to protect the ovarian and preserving their fertility ability.

目的研究生殖医学专科感染的预防与护理管理，提高医院感染管理质量。方法采用回顾性总结的方法，总结相应的控制措施。结果最大限度地控制了院内感染发生率，保证了患者及医务人员的健康安全。结论制度健全、人员重视、控制措施得当，院内感染得到了有效预防。

Objective To investigate the sleep quality of in vitro fertilization and embryo transfer ( IVF-ET)patients.Methods A total of 92 patients were selected and accepted fertility treatment from October to November, 2012.Then, we investigated their sleep quality using the Pittsburgh sleep quality index ( PSQI) scale.Results Among the 92 IVF-ET patients, 19 patients ( 20.6%) at the first day during period , 43 patients (46.7%) on the day of oocyte retrieval , and 42 patients (45.6%) on the seventh day after embryo transfer got a score of PSQI over 7, which indicated that a number of patients who had experienced sleep disorders and the problem remained at a high level .At the first day during period , IVF-ET patients ’ score of PSQI in sleep quality, the time to fall asleep, sleep time, sleep efficiency, sleep disorders, daytime dysfunction, and the total score were (0.89 ±0.64), (0.96 ±0.75), (0.89 ±0.69), (0.46 ±0.76), (1.08 ±0.60), (1.05 ±0.72) scores, and (4.78 ±2.39), respectively, which were higher than the norm score of (0.63 ±0.68), (0.70 ±0.86), (0.70 ±0.58), (0.15 ±0.47), (0.90 ±0.44), (0.73 ±0.83), and (3.88 ±2.52) scores.The differences were significant (t=2.795 6, 2.274 8, 2.141 8, 3.412 9, 2.424 4, 2.922 3, 2.597 7, respectively;P<0.05).On the day of oocyte retrieval, IVF-ET patients’ score of PSQI in sleep quality, the time to fall asleep, sleep time, sleep efficiency, sleep disorders, daytime dysfunction, and the total score were (1.22 ±0.55), (1.23 ±0.79), (1.17 ±0.72), (0.91 ±0.93), (1.24 ±0.54), (1.38 ±0.72), and (7.23 ±2.07) scores, respectively.On the seventh day after embryo transfer , those scores were (1.08 ±0.58), (1.27 ±0.68), (1.18 ±0.77), (0.90 ±0.88), (1.27 ±0.54), (1.43 ± 0.76), and (7.09 ±1.87) scores, respectively.Compared with the first day during period , the differences of scores were significant (F=7.067, 4.879, 4.829, 8.427, 3.231, 7.232, 38.521, respectively;P<0.05). Conclusions The sleep quality of IVF-ET patients were significantly decreased , so measures should be taken to improve the sleep quality during different stages of treatment .

介绍了生殖医学科利用本科室自主研发的具有本专业特色的电子信息化管理系统在护理工作的应用。本中心自主研发的电子信息化管理系统与医院CIS及NIS系统进行无缝链接，从而将辅助生殖技术过程中病例登记及病案管理、医嘱执行、围手术期管理、随访管理、科研统计等功能紧密衔接，实现了辅助生殖技术管理的规范化、流程化及信息化，提高了护理质量、工作效率和管理能力，促进了整个生殖医学工作的良性循环。

目的:分析生殖专科行体外受精-胚胎移植(IVF-ET)取卵术后患者发生跌倒的高危因素,以探讨有效的预防措施。方法:回顾本中心2006年6月-2011年12月发生3起取卵术后意外跌倒患者的资料。结果:药物反应、手术创伤、患者及家属安全意识、护理人员因素等是患者跌倒的高危因素。结论:应针对取卵术后患者存在的高危因素,强化医护人员及患者、家属的安全意识,制定有效的防范措施及健康教育,并落实到位,从而避免取卵术后患者发生跌倒意外。

目的 探讨心理护理对体外授精-胚胎移植(IVF-ET)成功率的影响.方法 选择2010年5～ 10月在本院生殖中心接受IVF-ET的患者286例,随机分为心理护理组和对照组,心理护理组152例,对照组134例,比较两组妊娠结局.结果 两组患者平均年龄、FSH基础值、接受IVF治疗的次数、Gn支数、Gn天数、平均获卵数、平均移植胚胎数、移植胚胎评分、子宫内膜厚度均无显著性差异(P＞0.05).但是心理护理组临床妊娠率高于对照组,流产率低于对照组(P＜0.05).结论 适当的心理护理能有效地减轻患者的紧张情绪和思想压力,使患者主动配合治疗,对提高IVF-ET的成功率有重要意义.

目的探讨早期妊娠阴道B超引导下多胎妊娠减胎术的护理措施及其对保证手术顺利与改善多胎妊娠结局的作用。方法对2005年12月～2011年5月笔者所在中心收治的51例多胎妊娠要求行减胎术的患者,在早期妊娠行阴道B超引导下选择性减胎术,采用抽吸法或机械绞杀法。51例患者均进行术前心理护理和术后专科护理。结果 51例B超均显示转为双胎或单胎,成功率为100%。结论护士充分的术前准备、严格无菌操作,术前心理护理和术后专科护理对稳定患者情绪、保证手术顺利和母婴预后良好有重要作用。随着护理技术的完善,减胎术的成功率也提高。

空卵泡综合征(empty follicle syndrome,EFS)是体外受精(IVF)周期中比较少见且棘手的现象,因其发生预示着取消周期或不良结局,给医患双方带来巨大的精神打击和压力,影响患者的治疗信心及对未来周期产生恐惧感,已引起生殖医学工作者的重视.2009年本中心在781个IVF周期中有 3例为EFS临界状态,现将其临床资料报道如下,并结合相关文献复习,探讨EFS的病例特点及处理措施,为EFS的临床处理方法提供一种新的思路.

目的 探讨心理护理在体外受精-胚胎移植(IVF-ET)中的作用.方法 选取2009年1月～2009年12月在本中心行IVF-ET患者632例,随机分为两组:一组进行心理护理(n=320),一组进行常规护理,不实施心理护理(n=312).结果 进行心理护理组的患者在胚胎种植率及临床妊娠率显著高于对照组.结论 IVF-ET过程中心理护理有助于提高妊娠成功率.

随着促排卵药物的普遍应用以及体外受精-胚胎移植等辅助技术的广泛开展,多胎妊娠的发生率明显增加.多胎不仅给家庭和社会造成负担,而且孕妇在产科的并发症增多,流产率、围生儿患病率和病死率明显增加.为了提高活产率、胎儿的生存质量和减少多胎妊娠的不良后果,于孕早期行多胎妊娠减胎术是目前有效的补救措施[1].本文回顾性分析我院行阴道超声引导下孕早期多胎妊娠减胎术患者的临床资料,现报道如下.

<正>胚胎冷冻是辅助生育技术的一项重大进步,可以减少促排卵次数,增加累积妊娠率,在不适合移植胚胎的周期,还可将胚胎冷冻后再移植。影响冷冻胚胎移植成功率的因素很多,包括年龄、胚胎质量、

目的 通过对常规体外授精(IVF)失败(未观察到第二极体)后不同时间行补救性卵细胞浆单精子显微注射(ICSI)的临床资料比较,探讨补救性ICSI的最佳时间. 方法 回顾性分析常规体外授精(IVF)失败后6 h(早期组)与22 h(传统组)行补救性ICSI的临床资料,比较两组的受精率、卵裂率、优胚率、种植率和妊娠率. 结果 早期组受精率、种植率、临床妊娠率分别为74.6%(56/75)、37.5%(9/24)、53.8%(7/13);传统组受精率为63.0%(29/46)、种植率和临床妊娠率均为0.早期组7例妊娠中4例单胎,3例流产;早期组和传统组受精率比较,差异无统计学意义,妊娠率和种植率比较,差异有统计学意义(P<0.05); 结论 早期补救性ICSI在受精率、种植率和临床妊娠率上可能优于传统补救性ICSI.

健康体检已经成为人们预防疾病、发现疾病、提高生活质量的重要方式之一,对体检者进行健康教育也逐渐被广大医务人员所重视。健康教育能够帮助人们识别健康危险因素,建立健康行为,维护和促进健康。在健康体检中,我们适时开展形式多样、内容丰富的健康教育,并使健康教育工作贯穿于整个体检过程中的每一个环节,收到了良好的效果。

Objective:To investigate the aberrant expressions of TNF-α expression at fetomaternal interface during early spontaneous abortion.Methods:We identified TNF-α proteins in uteroplacental tissues from 30 early spontaneous aborters,25 normal early pregnant women,using immunohistochemistry.Results:We observed that the intensity of the immunohistochemistry signal of TNF-α in syncytiotrophoblastic and cytotrophoblastic cells of aborters was substantially higher than that of normal pregnant women(P0.01).Conclusion:These data clearly suggest that there is an involvement of TNF-α at the fetomaternal interface leading to spontaneous abortion.

随着人类寿命的延长,老年呼吸衰竭的发生日益增多.本院近年来收治50例慢性肺心病患者中,发生呼吸衰竭者占60%,现将护理情况介绍如下.